EFFECT OF A TOPICAL CORTICOSTEROID, A RETINOID AND A VITAMIN-D-3 DERIVATIVE ON SODIUM-DODECYL-SULFATE-INDUCED SKIN IRRITATION

Exposure of the skin to sodium dodecyl sulfate (SDS) leads to disrupti on of barrier and skin irritation. We used repetitive short exposure t o a low molarity SDS solution as an in vivo model to mimic the develop ment of irritant contact dermatitis. In this model, we studied clinica l (erythema), functional (transepidermal water loss(TEWL)) and cell bi ological changes. 24 healthy volunteers were patch tested with SDS (0. 2%) for 4 h a day for 5 consecutive days. After removal of the patches , the exposed sites were treated 1 x daily either with a topical corti costeroid (triamcinolon acetonide cream 0.05%), a retinoid (tretinoin cream 0.025%), or a vitamin D-3 derivative (calcipotriol ointment 50 m icrogram/g). Irritant reactions were assessed by erythema scoring and measurement of barrier function with TEWL up to 14 days after the firs t challenge. Skin biopsies were taken for cell biological changes at d ay 4. Vehicle-treated sites served as controls. Repetitive exposure of human skin to SDS resulted in a gradual increase in erythema scoring and TEWL associated with the upregulation of proliferative cells as me asured by the expression of Ki-67-antigen and of differentiation marke rs, visualized by increased expression of involucrin and epidermal-fat ty-acid binding protein (E-FABP). Skin irritation as assessed by eryth ema scoring and TEWL was not significantly suppressed by triamcinolone cream. However, a significant reduction of the number of cycling kera tinocytes and a decrease in involucrin positive cell layers was observ ed in this group. Neither treatment with calcipotriol ointment nor wit h tretinoin cream induced improvement of skin irritation as judged by visual scoring and TEWL. In contrast to steroid treatment, no signific ant effect of calcipotriol ointment or tretinoin cream treatment was o bserved with regard to the number of cycling cells and differentiation markers. Further studies are needed to assess whether treatment with topical corticosteroids is an effective modality in skin irritation an d irritant contact dermatitis. (C) Munksgaard, 1997.